Context : D0 ental caries is the most common oral disease that affects significant number of Indian population. The prevalence of caries in India is reported 31.5% to 89%.
Aims : T0 his study was aimed to estimate the prevalence of dental caries and treatment needs in school going children of Delhi.
Materials and Methods : A0 school based cross-sectional study was conducted in various educational zones of Delhi. A total of 520 school children in age range of 9-12 years were examined using WHO (1997) criteria.
Statistical Analysis Used : C0 hi-square test.
Results : T0 he prevalence of dental caries was found to be 52.3% with mean deft and DMFT of 0.5038 ± 1.0859 and 0.8250 ± 1.3437, respectively. Besides various treatment needs 49.7% required restorative treatment.
Conclusion : T0 he prevalence of dental caries in Delhi school children is high with D+d components comprising of more than 95%. This indicates lack of awareness and affordability to the dental facilities available. Therefore, there is a need to develop preventive and promotional oral health strategies to combat this infectious disease.

How to cite this article:
Grewal H, Verma M, Kumar A. Prevalence of dental caries and treatment needs amongst the school children of three educational zones of urban Delhi, India.Indian J Dent Res 2011;22:517-519

Dental caries is a global oral health problem which can be effectively prevented and controlled through a combination of individual, community and professional efforts. In order to prevent and control the dental caries, one should know its exact nature of occurrence and distribution in the community. The global distribution of dental caries has shown distinctive variations. [1] The scenario in India also shows similarities with other developing countries. Prevalence studies on dental caries in India have shown a results ranging from 31.5% to 89%. [2],[3],[4],[5],[6],[7],[8] This wide range may be attributed to diverse geographic, climate, cultural, ethnic and socioeconomic conditions in India.

National oral health survey [9] 2002-03 reported 53.8% of overall caries prevalence in India at the age of 12 years where as in Delhi this figure was slightly lower i.e. 46.8%. Delhi is one of the largest metropolis of India with the population of 13.8 million (2001 Census) and literacy rate of 81.5%. The 93.17% of the total population is residing in urban areas. The national capital territory of Delhi comprise of 9 districts, 27 tehsils, 3 statutory towns viz. Municipal Corporation of Delhi (MCD), New Delhi Municipal Council (NDMC) and Delhi Cantonment Board (DCB), 59 census towns and 165 villages.

Very few caries prevalence studies of Delhi school children have been reported in past. [2],[9] To know the present status of dental caries, this study was planned with the following aims and objectives:

To determine the prevalence of dental caries in school going children of Delhi.To evaluate the treatment needs of the study population.

Materials and Methods

A school based cross-sectional study was carried out in three educational zones (i.e. Central, South and North-West) of urban Delhi selected as per convenience. The total population of these three zones is 5.7 million and the sample size was statistically analysed on the basis of reported caries prevalence in India [2],[3],[4],[5],[6],[7],[8] i.e. 31.5% to 89%. Assuming the caries prevalence of 50% with error of 5% and power of the study to be 90%, the minimum sample size calculated was 390. From each Educational zone, one school was selected at random. Necessary permissions were obtained from the concerned authorities. Out of the five selected schools, about 100 children in the age range of 9-12 years were examined. A total of 520 children were surveyed comprising of 333 boys and 187 girls. The children were examined by a single trained examiner in their respective schools seated on an ordinary chair in broad day light facing away from direct sunlight using WHO (1997) criteria. The distribution of sample is given in [Table 1].{Table 1}

The data was compiled and statistically analyzed using SPSS software. The Chi-square test was applied.

Results

The prevalence of dental caries in study sample was found to be 52.3% [Table 2]. The caries prevalence amongst boys was 50.45% and of girls was 55.61%. The difference between boys and girls was non-significant (P = 0.6468; >0.05) [Table 3]. The mean deft and DMFT were 0.5038± 1.0859 and 0.8250 ± 1.3437, respectively [Table 4] and [Table 5].{Table 2}{Table 3}{Table 4}{Table 5}

While assessing the treatment needs, it was found that 27.6% children required one surface filling, 22.1% two or more surface fillings, 19.4% children required fissure sealants and preventive care, remaining 5.1% required pulp care, 3% extraction, 0.8% crown, and 1.3% had other care needs [Table 6].{Table 6}

Discussion

The prevalence of dental caries in the present study was found 52.3% which is almost similar to the reported caries prevalence of India (i.e. 53.8%) in National Oral Health Survey. [9] Almost similar caries prevalence has been reported by Das et al., [10] Rodrigues and Damle [11] and Shourie. [12] In the present study the sample was collected from three out of nine educational zones of Delhi. The child population exhibited caries prevalence of more than 60% till the age of 11 years and showed a decline to 36% at age of 12 years. The difference observed can be attributed to the fact that the carious deciduous first and second molars are replaced by newly erupted premolars by the age of 12 years without showing an increase in the filled component. Dash et al. [6] also observed the pattern in which caries were increasing from 5 years to 8 years and subsequently decreased at 11 and 15 years. Further, caries prevalence was found to be increasing from age of 9 to 11 years and d-component of deft showed a gradual decline. This pattern is not seen by other authors [7],[8] and it reflects that the total number of children affected by caries is increasing over the years whereas decayed component per child is decreasing during the late mixed dentition period. This decline in d-component may be attributed to wide spread use of fluoride dentifrices because these days all the major brands of toothpaste contain fluoride.

While analyzing the caries prevalence of Delhi at 12 year of age, Shourie [2] reported prevalence of 54.8%, Hari Prakash et al. in National Oral Health Survey [9] reported 46.8% caries prevalence. The present study shows 52.3%, the results indicate a steady increase in the prevalence of dental caries; this gradual increase may be attributed to the fast changing lifestyles and eating habits of the metropolis.

Further, analyzing DMFT+ deft, D+d component constitutes more than 95%, which indicate lack of knowledge, positive attitudes and affordability to the dental facilities available. As far as the treatment needs are concerned, around 50% of all the treatment needs are restorative in nature. Dash et al., [6] Dhar et al. [7] and Sarananan et al. [8] had also found the higher restorative need of treatment. When analyzing the treatment needs amongst the different age groups, it was found that need of preventive and fissure sealants is higher at age group of 9 and 12 years. It could be because of non carious deep fissured permanent first molar at 9 years age group and permanent second molar at 12 years age group. At 10 and 11 years of age highest treatment need is restorative in nature which is likely to be due to involvement of deciduous molars by caries. Data of treatment needs provide a basis for type of treatment required for a population and with the existing infrastructure and manpower facilities, it is difficult to provide curative treatment to such a vast and diverse population as access and affordability to the dental facilities become a constraint for majority of the population. The curative approach is limited only to the people who can afford the expenses and impose a financial burden on the remaining population. Therefore, for effective management of dental caries, emphasis should be laid upon designing suitable preventive and promotional oral health strategies.

Conclusion

The prevalence of dental caries in Delhi school children is high with D+d components comprising of more than 95%. This indicates lack of awareness and affordability to the dental facilities available. Therefore, there is a need to develop preventive and promotional oral health strategies to combat this infectious disease.